Using Vasectomies as Birth Control: What You Need to Know

Each year, more than 500,000 people head to their healthcare provider's office to get what is sometimes to referred to as "the snip"—or avasectomy．This simple, non-invasive surgical procedure is a highly effective form of pregnancy prevention and is among the most commonly used means of birth control.

"It is recommended for men and their partners who are interested in permanent contraception," saysStephen Lazarou, MD, FACSa reproductive urologist, men’s health specialist, and director of urology at Boston IVF as well as a clinical instructor at Harvard Medical School.

Because of its effectiveness and permanence, many urologists across the country are reporting an increased interest in vasectomies in the wake of theRoe v. Wade supreme court ruling．While there are a number of reasons people are looking into and getting vasectomies, some are pursuing the procedure because they are worried about access to abortion should their partner need one—especially if they are finished building their family.

"We have experienced an uptick in vasectomy procedures," says Dr. Lazarou. "There has been an increased interest in—and conversation about—the procedure that is a direct result of the Roe v. Wade decision. In fact, several patients have specifically mentioned the decision [as a reason for their inquiry]."

If you are considering a vasectomy, but are not sure if it is the right choice for your family, read on. Here we help you make sense of what the procedure involves, its effectiveness, its reversibility, and what to consider before getting one.

What Is a Vasectomy?

A vasectomy, or sterilization, is a minor surgical procedure designed to block sperm from reaching the semen that is ejaculated. This procedure is a form of birth control that many families choose, and is considered permanent.

Typically, a vasectomy is performed by a urologist in their office—though the procedure may also be done in a hospital or surgery center if the physician prefers. This minimally-invasive procedure usually lasts about 20 minutes and is done under local anesthesia, so you will be awake but will not feel anything. After a vasectomy, the body still makes sperm, but it cannot get to the semen.

"The testicles can and do produce sperm but are obstructed," says Dr. Lazarou. "In other words, the factory is still going, but the sperm hits a dead end where the body breaks down the sperm, and it is absorbed into the body."

There are two primary types of vasectomies that people can choose from. These include standard vasectomies and no-scalpel vasectomies.

Standard Vasectomy

With this type of vasectomy, there are two small incisions made to the skin of the scrotum. Then, the vas deferens—the tubes that carry sperm—are cut and the tubes are removed. From there, the tubes are tied or cauterized, which involves using an electrical current to close the wound. Then the tube is replaced inside the scrotum and the skin is closed with stitches that later dissolve.

No-Scalpel Vasectomy

This procedure involves making a tiny puncture hole via a small clamp with pointed ends, rather than making a cut. This allows the healthcare provider to lift the vas deferens out, cut them, seal them, and put them back in place. Not only are stitches not required with this method, but there also is a lower risk of complications.

How Effective Is Vasectomy as Birth Control?

A vasectomy prevents华体会体育官方人口better than any other method of birth control, except abstinence, saysGregory Lowe, MD, a urology specialist with OhioHealth, a family of healthcare facilities in central Ohio. In fact, only one out of 2,000 people will get pregnant after their partners have had a vasectomy.

Not only are vasectomies an incredibly reliable form ofbirth control他们是99.9%有效的,劳博士补充道。Meanwhile, other forms of birth control—like the pill, condoms, and the withdrawal method—do not even come close to being as effective. Only IUDs and tubal ligation have remotely similar levels of effectiveness, he says.

Vasectomies, which are the fourth most common form of birth control in the U.S., are intended to be a permanent form of birth control.That said, it's important to note that vasectomies do not protect against sexually transmitted diseases (STDs). Consequently, consistent and correct use of condoms is recommended even with a vasectomy to reduce the risk for STDs, including HIV.

How to Decide If a Vasectomy Is Right For You

The decision to get a vasectomy is a very personal choice. It should not be made without some serious thought and honest discussions with your partner—if you have one—as well as your healthcare provider.

Not only do you need to understand how the procedure will be performed, but you also should know what the recovery will entail. Here are some things you might want to think about as you make your decision.

You'll Likely Need a Post-Operative Semen Analysis

Most healthcare providers recommend that you return to the office for asemen analysisto make sure the procedure was successful. In fact, a vasectomy is not considered successful until after your semen has been tested to make sure it doesn't contain sperm.

For this reason, you must use some form of birth control to prevent unwanted pregnancy until you know for sure your semen is free of sperm. This testing is usually done about two months after the procedure, says Dr. Lowe.

"Only about 45% of patients come back to do the semen analysis," Dr. Lowe says. "Generally, they wait a couple of months and then just take their chances."

再保险cognize the Permanence of the Procedure

It's important to know that a vasectomy is meant to be a permanent form of birth control. And while there are some urologists—like Dr. Lazarou and Dr. Lowe—who can perform the more complex reversal surgery of reconnecting the vas deferens, it is best to consider this procedure a one-time process that ends your ability to impregnate another person.

"You are not a good candidate for [the procedure] if you are not prepared for the permanence of vasectomy," says Dr. Lazarou. "There are options for reversal, but they may not work for all people. There is also the option to extract sperm and go immediately to试管婴儿．但重要的是接近输精管切除术作为permanent, and it has to be the right choice for the family."

Decide What's Best for You and Your Family

Most people who consider having a vasectomy are finished building their family. Couples might also consider a vasectomy when they do not want to use, or cannot use, other forms of birth control, Dr. Lowe says. They also may be in a situation where a pregnancy would be unsafe, or one or both partners have agenetic disorderthat they do not want to pass on to a child.

"Frequently, we are seeing OB/GYNs refer the partners of patients that want to go off of hormonal forms of birth control," says Dr. Lowe. "We also see situations where the anesthesia required for the female partner to undergo [tubal ligation] would be a higher risk than for the other partner to get a vasectomy. It [might be] easier for the man to have a vasectomy than it is for a woman to have a surgical procedure [for tubal ligation], and there are fewer long-term risks than using oral contraceptives."

Make Sure You're Comfortable With the Procedure

While getting a vasectomy is a relatively simple procedure with very little risk, you still need to be sure you are comfortable with it. Ask questions so that you are familiar with what will happen and what the recovery will be like.

In general, people who get a vasectomy are able to return to work within two to three days. They also may experience some swelling and bruising after the procedure, but this usually goes away within two weeks. Additionally, they can typically engage in sexual activity when they feel ready, which for most people is about one week after the procedure.

Dr. Lowe indicates that many patients often worry that their bodies will experience a noticeable change after a vasectomy. But he says that everything should stay the same. People who have a vasectomy should still experience erections, their sex drive should not decrease, and their testosterone levels will not change.

"I want to emphasize that this is a simple procedure that is not going to change any of their sexual function," he says. "In fact, some studies have shown that men who have had a vasectomy have sex more frequently than men who have not."

Things to Keep in Mind About Vasectomies

It is important to remember that a vasectomy is intended to be a permanent form of birth control. Yet many couples go into it thinking that if they change their mind, they can always get it reversed. However, it is not always that simple.

"Like most things in life, it is much easier to take it apart than it is to put it back together," says Dr. Lowe. "A reversal is a longer procedure than a vasectomy and it is not typically not covered by insurance. For a person considering a reversal, they have the best chance of success if they find someone who does reversals routinely."

Dr. Lazarou suggests that if people think they may want the option to have another child, they should considercryopreserving spermprior to a vasectomy procedure. It also is possible that the sperm can be extracted and used in IVF after a vasectomy because the testicles are still making sperm.

"These options sometimes give patients peace of mind," he says. "I usually mention them to patients at the time of the consultation."

也就是说,它也可以是昂贵的a vasectomy reversal and even more expensive to utilize IVF. For this reason, most urologists stress that patients be sure they understand what it means for theirfertilityto get a vasectomy. If they are not sure, or if they are wavering, it may not be the best time to undergo the procedure.

"They need to really consider what is the likelihood of wanting more children in the future," Dr. Lowe says. "While a reversal often can be done, it is not 100% guaranteed. Plus, it is expensive. It can cost as much as $8,000 for a reversal, and more than $12,000 for a cycle of IVF."

A Word From Verywell

For couples who are finished building their family, a vasectomy can be a safe and economical form of birth control. Plus, it is one of the most effective forms of contraception aside from abstinence.

If you are considering vasectomy for your family, it's important to fully understand the procedure and what it will mean for your fertility. While there is a chance that vasectomies can be reversed, they are intended to be a permanent form of birth control and should not be utilized if you think there is even a small chance you might want another child.

Talk to your healthcare provider about the option of a vasectomy so that you understand what is involved. They can answer your questions and help you determine if it is right for you and your family.